[Jean]

Donna,

Many have been frustrated by the fact that oncologists have considered all breast cancers the same in terms of the risk is determined by both size and lympth node status. I have always refuted this criteria esp. with Her2 +
I would like to share the following:

HER2 Status Associated With Recurrence in Node-Negative Breast Cancer Presented SSO
March 19,2007 - Absesence of cancerous cells in sentinel lympth notes (SLN)
is generally taken as prediciting good prognosis in breast cancer. But, according to research presented at the 60th annual meeting of the Society of Surgical Oncology (SSO) node-negative patients whose tumors express the HER2 protein may be at higher than expected risk for cancer recurrance. Julie E. Lang, MD surgical oncology fellow, University of Texas MD Anderson Cancer Center Houston Tx, reported on a retrospective analysis of women who underdwent primary breast tumours resection and SLN dissection. The research was performed at her former institution, the University of California-San Francisco. Dr. Lang's analysis included 307 patients who were found to be SLN negative. Of these 53 had primary tumours that were postive for HER2 by immunohistochemistry and or fluorescent hybridiization in situ methods, while 198 were HER2-negative and the remaing 56 had inconclusive or missing data on HER2 status. Patients were followed for a mean of 4.1 yrs. In a poster presentation March 16th Dr. Lang said that this is one of the larger studies to look at HER2 status as a prognostic factor in node-negative breast cancer. Results of the analysis that HER2 postivie patients in the series were significantly more likely to have cancer recurrence-both systemic and locoregional - and had a higher mortality rate. Recurrance free survival was markedly worse in HER2 positive women. The analysis found no significant association between HER2 and SLN status. In short the study
suggested that negative SLN findings do not necessarily predict good prognosis in HER2 positive patients.

When I was dx. the dr's were strongly confident due to my node status and tumor size...then I began to do my homework. Postive HER2 status in contract is sufficient to upgrad a node negative patient to the intermediate risk category. HER2 like to travel....

Also - to clear up any confusion I may have created regarding ages...
I did not mean that 50 was a cut off for chemo, rather what I was attempting to state to you was that "all woman" regardless of being 30 or 50 want to
have the best treatment possible. I have also noticed (at least in my cancer center) that the majority of the patients are not on the younger side, rather
more are 45 and over....with a great many over 60 +...and are doing
well with their cancer treatments. There are so many new advancements
with controlling the side effects today compared with just a short few years ago. Also, and this is the most important - we still do not know why or who
will respond to herceptin. Hopefully in the near future we will have more answers - but we do know that herceptin is working for a good majority of woman. We also now know that herceptin works best with chemo...
you are also very lucky that herceptin is given as a treatment to women who's cancer has not spread...this was not the case up to last August when
Herceptin was finally approved for non-metastatic patients. Please note
Sheila's post/ and Becky's post....once again, realize that a diagnosis of cancer does not mean instant doom. You will help your cousin make careful decisions. Please let us know how your cousin is....wishing you all the best.

Jean